Warfarin prevalence, indications for use and haemorrhagic events
| dc.contributor.author | Quirke, William | |
| dc.contributor.author | Cahill, Mary R. | |
| dc.contributor.author | Perera, Kanthi | |
| dc.contributor.author | Sargent, Jeremy | |
| dc.contributor.author | Conway, Jane | |
| dc.date.accessioned | 2011-11-28T17:07:05Z | |
| dc.date.available | 2011-11-28T17:07:05Z | |
| dc.date.issued | 2007-03 | |
| dc.date.updated | 2011-11-28T16:38:26Z | |
| dc.description.abstract | Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates.Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates. | en |
| dc.description.status | Peer reviewed | en |
| dc.description.version | Published Version | en |
| dc.format.mimetype | application/pdf | en |
| dc.identifier.citation | Ouirke, W.;Cahill, M.R.;Perera, K.;Sargent, J.;Conway, J. (2007) 'Warfarin prevalence, indications for use and haemorrhagic events'. Irish Medical Journal, 100 (3):402-404. | en |
| dc.identifier.endpage | 404 | en |
| dc.identifier.issn | 0332-3102 | |
| dc.identifier.issued | 3 | en |
| dc.identifier.journaltitle | Irish Medical Journal | en |
| dc.identifier.startpage | 402 | en |
| dc.identifier.uri | https://hdl.handle.net/10468/465 | |
| dc.identifier.volume | 100 | en |
| dc.language.iso | en | en |
| dc.publisher | Irish Medical Organization | en |
| dc.relation.uri | http://www.imj.ie//IMJPage_0_1.aspx?issueid=311#Original%20Papers | |
| dc.rights | © Irish Medical Journal 2007 | en |
| dc.subject | Warfarin | en |
| dc.subject.lcsh | Hemorrhage | en |
| dc.subject.lcsh | Anticoagulants (Medicine) | en |
| dc.title | Warfarin prevalence, indications for use and haemorrhagic events | en |
| dc.type | Article (peer-reviewed) | en |
